{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T09:26:06Z","timestamp":1785403566090,"version":"3.56.0"},"reference-count":49,"publisher":"AOSIS","issue":"1","license":[{"start":{"date-parts":[[2025,4,30]],"date-time":"2025-04-30T00:00:00Z","timestamp":1745971200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:p>Road Traffic Incidents (RTIs) are a major public health concern worldwide, particularly in low-income to middle-income regions such as sub-Saharan Africa. Data from sub-Saharan Africa suggests that the public transport industry accounts for the majority of fatal crashes that contribute to the high mortality and morbidity associated with RTIs. In this viewpoint, we advocate for integrated and comprehensive evidence-based health and safety interventions to address the challenge of RTIs in the public transport industry in sub-Saharan Africa. We provide evidence on the magnitude of the problem drawing on the state of mortality and morbidity and reported challenges associated with RTIs in the minibus taxi industry in South Africa as this is the most common mode of public transport in the region.<\/jats:p>","DOI":"10.4102\/phcfm.v17i1.4570","type":"journal-article","created":{"date-parts":[[2025,4,26]],"date-time":"2025-04-26T09:32:19Z","timestamp":1745659939000},"update-policy":"https:\/\/doi.org\/10.4102\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Promoting health and safety in public transportation: A call to action for sub-Saharan Africa"],"prefix":"10.4102","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8021-4129","authenticated-orcid":false,"given":"Gugu G.","family":"Mchunu","sequence":"first","affiliation":[{"id":[{"id":"https:\/\/ror.org\/0303y7a51","id-type":"ROR","asserted-by":"publisher"}],"name":"Durban University of Technology"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2150-9706","authenticated-orcid":false,"given":"Dudu G.","family":"Sokhela","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/0303y7a51","id-type":"ROR","asserted-by":"publisher"}],"name":"Durban University of Technology"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9907-279X","authenticated-orcid":false,"given":"Yugan","family":"Pillay","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/0303y7a51","id-type":"ROR","asserted-by":"publisher"}],"name":"Durban University of Technology"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-1087-3633","authenticated-orcid":false,"given":"Ivan","family":"Niranjan","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/0303y7a51","id-type":"ROR","asserted-by":"publisher"}],"name":"Durban University of Technology"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2453-7948","authenticated-orcid":false,"given":"Celenkosini T.","family":"Nxumalo","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/00h2vm590","id-type":"ROR","asserted-by":"publisher"}],"name":"University of the Western Cape"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2580","published-online":{"date-parts":[[2025,4,30]]},"reference":[{"key":"ref0","doi-asserted-by":"crossref","unstructured":"Ul Baset MK, Rahman A, Alonge O, Agrawal P, Wadhwaniya S, Rahman F. Pattern of road traffic injuries in rural Bangladesh: Burden estimates and risk factors. Int J Environ Res Public Health. 2017;14(11):1354. https:\/\/doi.org\/10.3390\/ijerph14111354","DOI":"10.3390\/ijerph14111354"},{"key":"ref1","doi-asserted-by":"crossref","unstructured":"Zafar SN, Canner JK, Nagarajan N, et al. Road traffic injuries: Cross-sectional cluster randomized countrywide population data from 4 low-income countries. Int J Surg. 2018;52:237\u2013242. https:\/\/doi.org\/10.1016\/j.ijsu.2018.02.034","DOI":"10.1016\/j.ijsu.2018.02.034"},{"key":"ref2","unstructured":"WHO. Global status report on road safety 2018. Geneva: World Health Organization; 2018."},{"key":"ref3","doi-asserted-by":"crossref","unstructured":"Ogunyemi KO, Alao DO, Adam EM, Malolan C, Olaomi O. Road safety in low- and middle-income countries: Role of police strike. J Glob Health. 2022;12:03070. https:\/\/doi.org\/10.7189\/jogh.12.03070","DOI":"10.7189\/jogh.12.03070"},{"key":"ref4","doi-asserted-by":"crossref","unstructured":"Bachani A, Peden M, Gururaj G, Norton R, Hyder A. Road traffic injuries. Washington, DC: World Bank Publications; 2017.","DOI":"10.1596\/978-1-4648-0522-6_ch3"},{"key":"ref5","doi-asserted-by":"crossref","unstructured":"Nantulya VM, Sleet DA, Reich MR, Rosenberg M, Peden M, Waxweiler R. Introduction: The global challenge of road traffic injuries. Inj Contr Saf Promot. 2003;10(1\u20132):3\u20137. https:\/\/doi.org\/10.1076\/icsp.10.1.3.14109","DOI":"10.1076\/icsp.10.1.3.14109"},{"key":"ref6","doi-asserted-by":"crossref","unstructured":"Alam K, Mahal A. The economic burden of road traffic injuries on households in South Asia. PLoS One. 2016;11(10):e0164362. https:\/\/doi.org\/10.1371\/journal.pone.0164362","DOI":"10.1371\/journal.pone.0164362"},{"key":"ref7","doi-asserted-by":"crossref","unstructured":"Sengoelge M, Laflamme L, El-Khatib Z. Ecological study of road traffic injuries in the eastern Mediterranean region: Country economic level, road user category and gender perspectives. BMC Public Health. 2018;18(1):1\u20139. https:\/\/doi.org\/10.1186\/s12889-018-5150-1","DOI":"10.1186\/s12889-018-5150-1"},{"key":"ref8","doi-asserted-by":"crossref","unstructured":"Staton C, Vissoci J, Gong E, et al. Road traffic injury prevention initiatives: A systematic review and metasummary of effectiveness in low and middle income countries. PLoS One. 2016;11(1):e0144971. https:\/\/doi.org\/10.1371\/journal.pone.0144971","DOI":"10.1371\/journal.pone.0144971"},{"key":"ref9","doi-asserted-by":"crossref","unstructured":"Bhalla K, Mohan D, O\u2019Neill B. How much would low- and middle-income countries benefit from addressing the key risk factors of road traffic injuries? Int J Inj Contr Saf Promot. 2020;27(1):83\u201390. https:\/\/doi.org\/10.1080\/17457300.2019.1708411","DOI":"10.1080\/17457300.2019.1708411"},{"key":"ref10","doi-asserted-by":"crossref","unstructured":"Marquez PV, Farrington JL. The challenge of non-communicable diseases and road traffic injuries in sub-Saharan Africa: An overview. Washington, DC: World Bank Publications; 2013.","DOI":"10.1596\/16451"},{"key":"ref11","doi-asserted-by":"crossref","unstructured":"Sukhai A, Govender R, Van Niekerk A. Fatality risk and issues of inequity among vulnerable road users in South Africa. PLoS One. 2022;16(12):e0261182. https:\/\/doi.org\/10.1371\/journal.pone.0261182","DOI":"10.1371\/journal.pone.0261182"},{"key":"ref12","doi-asserted-by":"crossref","unstructured":"Visagie S, Schneider M. Implementation of the principles of primary health care in a rural area of South Africa. Afr J Prim Health Care Fam Med. 2014;6(1):1\u201310. https:\/\/doi.org\/10.4102\/phcfm.v6i1.562","DOI":"10.4102\/phcfm.v6i1.562"},{"key":"ref13","doi-asserted-by":"crossref","unstructured":"Khalaf MK, Rosen HE, Mitra S, et al. Estimating the burden of disability from road traffic injuries in 5 low-and middle-income countries: Protocol for a prospective observational study. JMIR Res Protoc. 2023;12(1):e40985. https:\/\/doi.org\/10.2196\/40985","DOI":"10.2196\/40985"},{"key":"ref14","doi-asserted-by":"crossref","unstructured":"Vissoci JRN, Shogilev DJ, Krebs E, et al. Road traffic injury in sub-Saharan African countries: A systematic review and summary of observational studies. Traffic Inj Prev. 2017;18(7):767\u2013773. https:\/\/doi.org\/10.1080\/15389588.2017.1314470","DOI":"10.1080\/15389588.2017.1314470"},{"key":"ref15","doi-asserted-by":"crossref","unstructured":"Odonkor ST, Mitsotsou-Makanga H, Dei EN. Road safety challenges in sub-Saharan Africa: The case of Ghana. J Adv Transp. 2020;2020(1):7047189. https:\/\/doi.org\/10.1155\/2020\/7047189","DOI":"10.1155\/2020\/7047189"},{"key":"ref16","doi-asserted-by":"crossref","unstructured":"Borowy I. Road traffic injuries: Social change and development. Medical history. 2013;57(1):108\u2013138. https:\/\/doi.org\/10.1017\/mdh.2012.83","DOI":"10.1017\/mdh.2012.83"},{"key":"ref17","unstructured":"Muvuringi MP. Road traffic accidents in Zimbabwe, influencing factors impact and strategies. Amsterdam: Development policy and practice, Vrije Unuversity Amsterdam, KIT (Royal Tropical Institute); 2012."},{"key":"ref18","unstructured":"Peltzer K, Phaswana-Mafuya N, Arokiasamy P, et al. Prevalence, circumstances and consequences of non-fatal road traffi c injuries and other bodily injuries among older people in China, Ghana, India, Mexico, Russia and South Africa. Afr Safety Promoti: J Inj Violence Prev. 2015;13(2):59\u201377."},{"key":"ref19","doi-asserted-by":"crossref","unstructured":"Petrov AI. Road traffic accident rate as an indicator of the quality of life. Ekonomicheskie i Sotsialnye Peremeny. 2016(45):154. https:\/\/doi.org\/10.15838\/esc.2016.3.45.9","DOI":"10.15838\/esc.2016.3.45.9"},{"key":"ref20","unstructured":"Dalal K, Lin Z, Gifford M, Svanstr\u00f6m L. Economics of global burden of road traffic injuries and their relationship with health system variables. Int J Prev Med. 2013;4(12):1442."},{"key":"ref21","doi-asserted-by":"crossref","unstructured":"Kumeda B, Fengli Z, Oluwasanmi A, Owusu F, Assefa M, Amenu T. Vehicle accident and traffic classification using deep convolutional neural networks. 2019 16th International Computer Conference on Wavelet Active Media Technology and Information Processing; 2019 Dec 1; Chengdu, China. New York: IEEE; 2019. p. 323\u2013328.","DOI":"10.1109\/ICCWAMTIP47768.2019.9067530"},{"key":"ref22","doi-asserted-by":"crossref","unstructured":"Chen S, Kuhn M, Prettner K, Bloom DE. The global macroeconomic burden of road injuries: Estimates and projections for 166 countries. Lancet Planet Health. 2019;3(9):e390\u2013e398. https:\/\/doi.org\/10.1016\/S2542-5196(19)30170-6","DOI":"10.1016\/S2542-5196(19)30170-6"},{"key":"ref23","doi-asserted-by":"crossref","unstructured":"Albayati AH, Lateif RH. Statistical analysis of mortality and morbidity due to traffic accidents in Iraq. J Eng. 2018;24(1):20\u201340. https:\/\/doi.org\/10.31026\/j.eng.2018.01.02","DOI":"10.31026\/j.eng.2018.01.02"},{"key":"ref24","doi-asserted-by":"crossref","unstructured":"Blanchard EB, Hickling EJ, Taylor AE, Loos WR, Gerardi RJ. Psychological morbidity associated with motor vehicle accidents. Behav Res Ther. 1994;32(3):283\u2013290. https:\/\/doi.org\/10.1016\/0005-7967(94)90123-6","DOI":"10.1016\/0005-7967(94)90123-6"},{"key":"ref25","doi-asserted-by":"crossref","unstructured":"Ang BH, Chen WS, Lee SWH. Global burden of road traffic accidents in older adults: A systematic review and meta-regression analysis. Arch Gerontol Geriatr. 2017;72:32\u201338. https:\/\/doi.org\/10.1016\/j.archger.2017.05.004","DOI":"10.1016\/j.archger.2017.05.004"},{"key":"ref26","doi-asserted-by":"crossref","unstructured":"Ryan-Coker MFD, Davies J, Rinaldi G, et al. Economic burden of road traffic injuries in sub-Saharan Africa: A systematic review of existing literature. BMJ Open. 2021;11(9):e048231. https:\/\/doi.org\/10.1136\/bmjopen-2020-048231","DOI":"10.1136\/bmjopen-2020-048231"},{"key":"ref27","doi-asserted-by":"crossref","unstructured":"Onyemaechi N, Ofoma UR. The public health threat of road traffic accidents in Nigeria: A call to action. Ann Med Health Scie Res. 2016;6(4):199\u2013204. https:\/\/doi.org\/10.1080\/15389588.2017.1314470","DOI":"10.4103\/amhsr.amhsr_452_15"},{"key":"ref28","doi-asserted-by":"crossref","unstructured":"Juillard C, Labinjo M, Kobusingye O, Hyder AA. Socioeconomic impact of road traffic injuries in West Africa: Exploratory data from Nigeria. Inj Prev. 2010;16(6):389. https:\/\/doi.org\/10.4103\/amhsr.amhsr_452_15","DOI":"10.1136\/ip.2009.025825"},{"key":"ref29","doi-asserted-by":"crossref","unstructured":"Hyder AA, Labinjo M, Muzaffar SSF. A new challenge to child and adolescent survival in urban Africa: An increasing burden of road traffic injuries. Traffic Inj Prev. 2006;7(4):381\u2013388. https:\/\/doi.org\/10.1080\/15389580600942965","DOI":"10.1080\/15389580600942965"},{"key":"ref30","doi-asserted-by":"crossref","unstructured":"Sobngwi-Tambekou J, Bhatti J, Kounga G, Salmi L-R, Lagarde E. Road traffic crashes on the Yaound\u00e9\u2013Douala road section, Cameroon. Accid Anal Prev. 2010;42(2):422\u2013426. https:\/\/doi.org\/10.1016\/j.aap.2009.09.003","DOI":"10.1016\/j.aap.2009.09.003"},{"key":"ref31","unstructured":"Afolabi OJ, Gbadamosi K. Road traffic crashes in Nigeria: Causes and consequences. Transp Logist: Int J. 2017;17(42):2406\u20131069."},{"key":"ref32","doi-asserted-by":"crossref","unstructured":"Woyessa AH, Heyi WD, Ture NH, Moti BK. Patterns of road traffic accident, nature of related injuries, and post-crash outcome determinants in western Ethiopia-a hospital based study. Afr J Emerg Med. 2021;11(1):123\u2013131. https:\/\/doi.org\/10.1016\/j.afjem.2020.09.008","DOI":"10.1016\/j.afjem.2020.09.008"},{"key":"ref33","doi-asserted-by":"crossref","unstructured":"Verster T, Fourie E. The good, the bad and the ugly of South African fatal road accidents. S Afr J Sci. 2018;114(7\/8):63\u201369. https:\/\/doi.org\/10.17159\/sajs.2018\/20170427","DOI":"10.17159\/sajs.2018\/20170427"},{"key":"ref34","doi-asserted-by":"crossref","unstructured":"Peltzer K, Renner W. Psychosocial correlates of the impact of road traffic accidents among South African drivers and passengers. Accid Anal Prev. 2004;36(3):367\u2013374. https:\/\/doi.org\/10.1016\/S0001-4575(03)00017-4","DOI":"10.1016\/S0001-4575(03)00017-4"},{"key":"ref35","doi-asserted-by":"crossref","unstructured":"Ramukumba TS, Mathikhi MS. Health assessment of taxi drivers in the city of Tshwane. Curationis. 2016;39(1):1\u20137. https:\/\/doi.org\/10.4102\/curationis.v39i1.1671","DOI":"10.4102\/curationis.v39i1.1671"},{"key":"ref36","unstructured":"Alive A. Minibus taxis and road safety [homepage on the Internet]. 2023 [cited 2024 Jan 30]. Available from: https:\/\/www.arrivealive.mobi\/minibus-taxis-and-road-safety"},{"key":"ref37","unstructured":"Govender R, Allopi D. Towards a safer minibus taxi industry in South Africa. SATC. University of Pretoria Institutional Repository; 2006 [cited 2024 Jan 30]. Available from: https:\/\/repository.up.ac.za\/handle\/2263\/6052?show=full"},{"key":"ref38","unstructured":"De Beer LR, editor. Strategic assessment of the impact of the priority infrastructure on the perfomance of minibus-taxi services in the context of south africa. Southern African Transport Conference; 2019 Jul 8\u201311; Pretoria, South Africa. Pretoria: CSIR International Convention Centre; 2019. p. 1\u201310."},{"key":"ref39","doi-asserted-by":"crossref","unstructured":"Van Schoor O, Van Niekerk JL, Grobbelaar B. Mechanical failures as a contributing cause to motor vehicle accidents \u2013 South Africa. Accid Anal Prev. 2001;33(6):713\u2013721. https:\/\/doi.org\/10.1016\/S0001-4575(00)00083-X","DOI":"10.1016\/S0001-4575(00)00083-X"},{"key":"ref40","doi-asserted-by":"crossref","unstructured":"Peltzer K. Chapter 35 \u2013 Road use behavior in sub-Saharan Africa. In: Porter BE, editor. Handbook of traffic psychology. San Diego: Academic Press, 2011; p. 503\u2013518.","DOI":"10.1016\/B978-0-12-381984-0.10035-9"},{"key":"ref41","doi-asserted-by":"crossref","unstructured":"Chen G. Road traffic safety in African countries\u2013status, trend, contributing factors, countermeasures and challenges. Int J Inj Contr saf Promot. 2010;17(4):247\u2013255. https:\/\/doi.org\/10.1080\/17457300.2010.490920","DOI":"10.1080\/17457300.2010.490920"},{"key":"ref42","doi-asserted-by":"crossref","unstructured":"Deme D. Review on factors causes road traffic accident in Africa. J Civ Eng Res Tech. 2019;1(1):1\u20138. https:\/\/doi.org\/10.47363\/JCERT\/2019(1)101","DOI":"10.47363\/JCERT\/2019(1)101"},{"key":"ref43","unstructured":"WHO. Global status report on road safety: Time for action. Geneva, Switzerland: World Health Organization; 2009."},{"key":"ref44","doi-asserted-by":"crossref","unstructured":"Gudugbe S. Approaches to the effective prevention of road traffic injuries in sub-Saharan Africa: A systematic review. Open J Soc Sci. 2023;11(2):323\u2013344. https:\/\/doi.org\/10.4236\/jss.2023.112021","DOI":"10.4236\/jss.2023.112021"},{"key":"ref45","unstructured":"Sukhai A, Noah M, Prinsloo M. Road traffic injury in South Africa: An epidemiological overview for 2001. In: Suffla S, Van Niekerk A, editors. Crime, violence and injury prevention in South Africa: Developments and challenges. Tygerberg, South Africa: Medical Research Council-University of South Africa, Violence and Injury Lead Programme, 2004; p. 114\u2013127."},{"key":"ref46","doi-asserted-by":"crossref","unstructured":"Lefio \u00c1, Bachelet VC, Jim\u00e9nez-Paneque R, Gomol\u00e1n P, Rivas K. A systematic review of the effectiveness of interventions to reduce motor vehicle crashes and their injuries among the general and working populations. Rev Panam Salud Publ. 2018;42:e60. https:\/\/doi.org\/10.26633\/RPSP.2018.60","DOI":"10.26633\/RPSP.2018.60"},{"key":"ref47","doi-asserted-by":"crossref","unstructured":"Goniewicz K, Goniewicz M, Paw\u0142owski W, Fiedor P. Road accident rates: Strategies and programmes for improving road traffic safety. Eur J Trauma Emerg Surg. 2016;42(4):433\u2013438. https:\/\/doi.org\/10.1007\/s00068-015-0544-6","DOI":"10.1007\/s00068-015-0544-6"},{"key":"ref48","doi-asserted-by":"crossref","unstructured":"Morimoto A, Wang A, Kitano N. A conceptual framework for road traffic safety considering differences in traffic culture through international comparison. 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